Clinical validation of a model-based glycaemic control design approach and comparison to other clinical protocols (2006)
Type of ContentConference Contributions - Published
PublisherUniversity of Canterbury. Mechanical Engineering.
University of Canterbury. Mathematics and Statistics.
Hyperglycaemia is prevalent in critical care and tight control can reduce mortality from 9-43% depending on the level of control and the cohort. This research presents a table-based method that varies both insulin dose and nutritional input to achieve tight control. The system mimics a previously validated model-based system, but can be used for long term, large patient number clinical evaluation. This paper evaluates this method in simulation using retrospective data and then compares clinical measurements over 15,000 patient hours to validate the models and development approach. This validation thus also validates the in silico comparison to the landmark clinical tight glycaemic control protocols. Overall, an average clinical glucose level is 5.9 ± 1.0 mmol/L, matching simulation, however the overall clinical glucose distribution is slightly tighter than that obtained in simulation, indicating that the retrospective virtual trial design approach is slightly conservative. Finally, the model based approach is shown to have tighter control than existing, more ad-hoc clinical approaches based on the simulation results that qualitatively match reported clinical results, but also show significant variation around the average levels obtained in both the hypoand hyper-glycaemic ranges.
CitationChase, J.G., Shaw, G.M., Hann, C.E., LeCompte, A., Lonergan, T., Willacy, M., Wong, X.W., Lin, J., Lotz, T. (2006) Clinical validation of a model-based glycaemic control design approach and comparison to other clinical protocols. New York, NY, USA: 28th International Conference of IEEE Engineering in Medicine and Biology Society (EMBS 2006), 30 Aug-3 Sept 2006. Proceedings of the 28th International Conference of IEEE Engineering in Medicine and Biology Society (EMBS 2006), 4 pp.
This citation is automatically generated and may be unreliable. Use as a guide only.
Showing items related by title, author, creator and subject.
Model-Based Insulin and Nutrition Administration for Tight Glycaemic Control in Critical Care Chase, Geoff; Shaw, Geoff; Lotz, T.; LeCompte, A.; Wong, J.; Lin, J.; Lonergan, T.; Willacy, M.; Hann, C.E. (University of Canterbury. Mechanical Engineering., 2007)Objective: Present a new model-based tight glycaemic control approach using variable insulin and nutrition administration. Background: Hyperglycaemia is prevalent in critical care. Current published protocols use insulin ...
A Simple Insulin-Nutrition Protocol for Tight Glycemic Control in Critical Illness: Development and Protocol Comparison Lonergan, T.; LeCompte, A.; Willacy, M.; Chase, Geoff; Shaw, Geoff; Wong, X.W.; Lotz, T.; Lin, J.; Hann, C.E. (University of Canterbury. Mechanical Engineering., 2006)Background: Hyperglycemia is prevalent in critical care, and tight control can significantly reduce mortality. However, current protocols have been considered taxing to administer and may require extra staff. In addition, ...
A Pilot Study of the SPRINT Protocol for Tight Glycaemic Control in Critically Ill Patients Lonergan, T.; LeCompte, A.; Willacy, M.; Chase, Geoff; Shaw, Geoff; Hann, C.E.; Lotz, T.; Lin, J.; Wong, X.W. (University of Canterbury. Mechanical Engineering., 2006)Background: Stress-induced hyperglycemia is prevalent in critical care, even in patients with no history of diabetes. Increased counter-regulatory hormone response increases gluconeogenesis and effective insulin resistance, ...